Robotic versus laparoscopic ipsilateral uretero-ureterostomy for upper urinary tract duplications in the pediatric population: A multi-institutional review of outcomes and complications

Chertin, Leon; Neeman, Binyamin B.; Stav, Kobi; Noh, Paul H.; Koucherov, Stanislav; Gaber, Jaudat; Zisman, Amnon; Chertin, Boris; Дубров, В. И.; Bondarenko, S.; Neheman, Amos

doi:10.1016/j.jpedsurg.2020.12.022

Cited by 10 publications

(5 citation statements)

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“…В работе L. Chertin и соавт. представлены 5-летние данные о результатах уретероуретеростомии у 66 пациентов, 46 из которых имели эктопию мочеточника, 9 -обструктивный мегауретер в связи с наличием уретероцеле, 11 -пузырно-мочеточниковый рефлюкс в мочеточник нижнего сегмента удвоенной почки [21].…”

Section: результатыunclassified

“…При этом авторы пришли к выводу, что обе методики являются эффективными и безопасными (лишь 1 пациент потребовал повторной операции в объеме удаления культи мочеточника по причине ее инфицирования). Однако роботическая техника признана более быстрой и не требующей у большинства пациентов дренирования забрюшинного пространства [21].…”

Section: результатыunclassified

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Ureteroureterostomy in case of renal duplication.

Kondrateva¹,

Kagantsov²,

Александровна³

et al. 2022

ECU

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Introduction. Kidney duplication is one of the most common urological developmental anomalies, the incidence of which is 0.8%. At the same time, various types of obstructive uropathy can be a concomitant pathology in such a situation. There are various methods for correcting obstructive uropathy. Currently, more and more often in the treatment of obstructive uropathy of one of the segments of the doubled kidney, a method such as ureteroureterostomy is used. However, there is still no consensus on which treatment tactics in this case is the most optimal. The aim of our work was to analyze literature about using ureteroureterostomy in patients with obstructive uropathies of a duplicated kidney, as well as to compare this technique with others. Materials and methods. Search results were analyzed in the scientific databases e-Library, PubMed, Medline, Web of Science, Embase, Cochrane Library and PEDro according to the following. keywords: «renal duplication», «heminephrectomy», «ureteroureterostomy», «obstructive uropathies». In total it was found 157 publications, after analyzing the literature, 33 papers were selected for review, most fully reflecting the topic. Results. Heminephrectomy is still popular for severely reduced or absent duplex kidney function, but it has complications such as decreased function of the remaining segment, pseudocyst formation, stump, urinoma, segmental hematoma, ureteral stricture, and vesicoureteral reflux into the remaining segment. Ureteroureterostomy, as an alternative method for correcting obstructive uropathies of a double kidney, has been recognized as effective and safe in many studies. Data are presented to prove that ureteroureterostomy is applicable for any function of the affected segment. In this article, various techniques for ureteroureterostomy are consecrated, from open intervention to robotic one. In addition, research data on the safety of ureteroureteroanastomosis in case of a pronounced discrepancy between the diameters of the ureters are presented. Among the complications of ureteroureteroanastomosis, cultitis, urine leakage in the anastomosis zone, urinoma, and stenosis of the anastomosis can be noted. The predictors of an unfavorable outcome of the proposed method were identified. These include ectopic ureterocele, hydronephrosis of both segments of the duplex kidney, as well as simultaneous ureteroureterostomy and reimplantation of the recipient ureter. Conclusions. Ureteroureterostomy in patients with various pathologies inherent in duplication of the kidney is an effective and safe technique that allows preserving the function of the segment and adequately draining it. The use of this technique does not depend on the presence of a decrease or lack of function of one of the segments.

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Section: результатыunclassified

Ureteroureterostomy in case of renal duplication.

Kondrateva¹,

Kagantsov²,

Александровна³

et al. 2022

ECU

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“…Duplicated kidney malformation is a common anomaly in the pediatric urinary system, with an incidence rate of 0.8–1% ( 1 ). Duplicated kidneys are classified into complete and incomplete types, with the former being more common than the latter.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

Tao,

Mao,

Cao

2024

Transl Pediatr

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Background Duplicated kidneys, though rare, are common in pediatric urinary issues. For children with complete kidney duplication and symptoms or complications, surgery is often needed. Ureteroureterostomy (UU) is a common procedure for this condition. This study aims to evaluate and compare the clinical efficacy and safety of laparoscopic ureteroureterostomy (LUU) and open ureteroureterostomy (OUU) in the treatment of pediatric duplicated kidneys. Methods A retrospective study at Children’s Hospital of Anhui Province from February 2017 to January 2023 included pediatric patients who underwent LUU or OUU for completely duplicated kidneys. Comparative measures included operative time, postoperative hospital stay, intraoperative blood loss, pre- and postoperative renal pelvis anteroposterior diameter, pre- and postoperative upper renal parenchymal thickness, pre- and postoperative upper ureteral diameter, and postoperative complications. Results There are 30 patients, 20 in the LUU group and 10 in the OUU group. All patients underwent surgery successfully, with no conversions to open surgery in the LUU group. Comparison between the LUU group (average age 3.7±3.4 years) and the OUU group (average age 1.6±1.3 years) showed that laparoscopic surgery had a mean duration of 178.8±60.71 min, intraoperative blood loss of 4.3±0.92 mL, drainage tube removal time of 1.8±0.6 days, and postoperative hospital stay of 4.2±2.2 days. In contrast, the OUU group had a mean surgery duration of 181.6±37.8 min, drainage tube removal time of 2.3±0.7 days, intraoperative blood loss of 6.4±4.06 mL, and postoperative hospital stay of 5.8±1.8 days. Although the LUU group had a shorter surgical duration, the difference was not statistically significant. However, intraoperative blood loss, drainage tube removal time, and postoperative hospital stay were significantly reduced in the LUU group, with statistical significance (P<0.05). After surgery, one case of urinary tract infection occurred in each group. Both groups had double-J stents placed postoperatively, which were removed cystoscopically 4–6 weeks later. Preoperative examinations showed no significant differences between the LUU and OUU groups in terms of upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness. However, in terms of postoperative recovery indicators, the LUU group outperformed the OUU group significantly, including upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness, with statistical significance (P<0.05). No hydronephrosis or worsening hydronephrosis was observed in the lower kidneys and ureters of the 30 patients postoperatively. Symptoms disappeared in patients with preoperative dribbling, and pain symptoms in the waist and abdomen relieved. No postoperative febrile urinary tract infections were observed. Conclusions UU is an effective and safe m...

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“…Duplex pelvis and ureter malformation is a frequently seen urinary malformation in children, and its incidence rate is 0.8%–1%, with a higher incidence in girls ( 1 ). It is classified into complete and incomplete types, with the former being more common than the latter.…”

Section: Introductionmentioning

confidence: 99%

A single-center study of two types of upper kidney preservation surgery for complete duplicated kidney in children

et al. 2022

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ObjectiveThe objectives of this study were to compare the efficacy, advantages, and disadvantages of insertable ureteral reimplantation (UC group) and ureteral end-to-side anastomosis (UU group) in the treatment of duplicated kidney and summarize the clinical experience in its diagnosis and treatment.MethodsThe current retrospective study enrolled 20 cases with duplicated kidney in Anhui Provincial Children's Hospital from April 2016 to June 2021, including 11 in the UC group and 9 in the UU group. There were 8 boys and 12 girls, with 12 on the left side and 8 on the right side. Meanwhile, there were three cases with urinary tract infection and nine with urinary incontinence. The rest of them were found by B ultrasound during physical examination. The median age of these patients was 33.5 months. Later, preoperative and postoperative renal pelvis separation, ureteral dilation, operation time, and drainage tube indwelling time were compared between the two groups.ResultsThere were statistically significant differences in operation time (282 ± 50.55 vs. 176 ± 61.92, P = 0.03), drainage time (9.36 ± 5.00 vs. 5.33 ± 1.22, P = 0.02), and hospital stay (22.18 ± 5.40 vs. 14.78 ± 5.33, P = 0.007) between the two groups. In addition, the degree of hydronephrosis (UC: 1.86 ± 0.93 vs. 1.08 ± 0.77, P = 0.00; UU: 1.8 ± 0.95 vs. 0.89 ± 0.60, P = 0.02) and ureteral dilatation (UC: 1.57 ± 0.30 vs. 0.72 ± 0.22, P = 0.00; UU: 1.47 ± 0.50 vs. 0.88 ± 0.22, P = 0.001) were statistically different between the two groups before and after surgery.ConclusionCompared with the UC method, the UU method has the advantages of less trauma, faster recovery, and fewer complications. Double J tube or ureter stent placement is beneficial for finding and protecting the lower ureter intraoperatively, without increasing the difficulty in operation, which can also prevent anastomosis or ureteral orifice stenosis.

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Robotic versus laparoscopic ipsilateral uretero-ureterostomy for upper urinary tract duplications in the pediatric population: A multi-institutional review of outcomes and complications

Cited by 10 publications

References 19 publications

Ureteroureterostomy in case of renal duplication.

Ureteroureterostomy in case of renal duplication.

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

A single-center study of two types of upper kidney preservation surgery for complete duplicated kidney in children

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